Healthcare Provider Details

I. General information

NPI: 1417108192
Provider Name (Legal Business Name): MARIA F BENDECK DO PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

1860 BOY SCOUT DR #201
FORT MYERS FL
33907-2119
US

V. Phone/Fax

Practice location:
  • Phone: 239-436-5000
  • Fax:
Mailing address:
  • Phone: 239-215-1180
  • Fax: 239-215-1179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS9335
License Number StateFL

VIII. Authorized Official

Name: MARIA F BENDECK
Title or Position: PRESIDENT
Credential: D.O.
Phone: 239-821-9547